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Organization
THE HEADACHE AND NEUROLOGY CLINIC PA
Active
Organization
THE HEADACHE AND NEUROLOGY CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. QAHTAN ABDULFATTAH MD (PRESIDENT)
(352) 596-8344
Entity
Organization
Contact information
Practice address
11373 CORTEZ BLVD STE 303, 303, BROOKSVILLE, FL 34613-5411
(352) 596-8344
(352) 597-2898
Mailing address
11373 CORTEZ BLVD STE 303, BROOKSVILLE, FL 34613-5411
(352) 596-8344
(352) 597-2898
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
ME92671
FL
Other
Enumeration date
03/08/2007
Last updated
07/06/2010
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